# Relating Vigilance to Connectivity and Neurocognition in Temporal Lobe Epilepsy

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2021 · $610,895

## Abstract

PROJECT SUMMARY/ABSTRACT
Temporal lobe epilepsy (TLE) is a devastating and common neurological disorder in which patients suffer from
frequent consciousness-impairing seizures, broad neurocognitive deficits, and diminished quality of life. Given
that seizures originate focally in the hippocampus or amygdala, why do TLE patients demonstrate cognitive
deficits not associated with temporal lobe function – such as decline in executive function, cognitive processing
speed, and attention – as well as diffuse decreases in neocortical metabolism and functional connectivity?
Given prior observations of reduced vigilance levels in TLE, and that seizures may disrupt the activity and long-
range connectivity of subcortical brain structures involved in vigilance regulation, we propose that subcortical
activating networks underlying vigilance play a critical role in mediating the widespread neural and cognitive
effects of focal TLE. Specifically, our central hypothesis is that recurrent consciousness-impairing seizures in
TLE may lead to functional connectivity disturbances between subcortical vigilance centers and cortex, leading
to impairments in vigilance state that may contribute to neurocognitive problems not explained by temporal
lobe dysfunction. To address this hypothesis, we plan human neuroimaging studies that relate vigilance to
brain connectivity (Aim 1), cognition to vigilance (Aim 2), and connectivity to cognition (Aim 3). In Aim 1, we will
characterize vigilance-dependent functional connectivity in healthy controls using simultaneous fMRI-EEG,
which will guide the selection of subcortical-cortical connections to probe in patients (Aim 3). In Aim 2, we will
relate individual neurocognitive parameters to vigilance measures in patients and controls, using a full
neuropsychological evaluation and assessments of psychomotor speed and excessive sleepiness, to
determine which cognitive deficits in patients are related to impaired vigilance. In Aim 3, we will compare MRI
measures of subcortical-cortical connectivity in patients vs. controls (focusing on areas uncovered in Aim 1) to
examine how long-range connections from subcortical activating structures are perturbed in TLE, and we will
relate these connectivity disturbances to neurocognitive deficits. Using this novel approach that integrates
multi-modal imaging with in-depth neurocognitive assessments, we expect to identify vigilance center
connectivity perturbations in TLE that influence vigilance state and may contribute to neurocognitive decline.
This work may help uncover subcortical neuromodulation targets and suggest the need for earlier surgical
intervention and behavioral therapies in this devastating disorder.

## Key facts

- **NIH application ID:** 10167802
- **Project number:** 5R01NS112252-03
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Catherine Elizabeth Chang
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $610,895
- **Award type:** 5
- **Project period:** 2019-08-15 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10167802

## Citation

> US National Institutes of Health, RePORTER application 10167802, Relating Vigilance to Connectivity and Neurocognition in Temporal Lobe Epilepsy (5R01NS112252-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10167802. Licensed CC0.

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